Expression of Generalized Anxiety Disorder Across the Lifespan

Abstract

In generalized anxiety disorder (GAD), both the associated symptoms and worry content have been shown to vary as a function of age (Jeste et al. Biological Psychiatry, 58, 265–271, 2005; Portman et al. Psychiatric Annals, 41, 79–85, 2011). However, few studies have conducted analyses beyond mean comparisons and no studies have examined whether the observed differences in worry content and the associated symptoms are due to the lack of measurement invariance across age groups. The current study evaluated whether the measurement and expression of GAD in adults varied as a function of age, using a clinical sample of 375 participants and dimensional measures of GAD. The sample was divided into three age groups (OLDER = 60+, MID = 40–59, YOUNG = 20–39), matched by sex and GAD status. Two associated symptoms were found to exhibit differential item functioning, overall distress/interference as well as fatigue, with higher levels distress/interference and lower levels of fatigue found in the OLDER age group despite equivalent GAD severity levels across groups. When examining the content of reported worries, differential item functioning was found in four worry domains. Holding the latent dimension of worry severity constant: (a) the YOUNG age group was found to have higher reported rate of social worries, and (b) the OLDER age group was found to have higher levels of reported worries about community/world affairs and health of self. The OLDER age group also exhibited lower levels of worry about work and school. These results are discussed with regard to the assessment of GAD across the lifespan.

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Funding

This research was funded by a grant from the National Institute of Mental Health (R01 MH039096; PI: Brown).

Compliance with Ethical Standards

Conflict of Interest

Jeannette K. Correa and Timothy A. Brown declare that they have no conflict of interest.

Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study received approval from the university’s Institutional Review Board.

Informed Consent

Informed consent was obtained from all individual participants included in the study.